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Sugars, acids and caries, and Xylitol

Ultimately caries or tooth decay is caused by acid breakdown of the enamel of the tooth. This acid is produced by A number of bacteria in the mouth, notably Streptoccocus mutans, that requires six carbon ring sugars as their feed substrate.When food is ingested, the sugars included in this food provide the fuel required by the bacteria, and acid production continues for approximately a half hour after each meal or snack, or until saliva and other factors are able to neutralise the acid. If people, including expectant mothers, snack regularly, the acid production increases proportionally.

Xylitol prevents caries through a number mechanisms :

1) Xylitol has been demonstrated to inhibit growth of Strep mutans by a starving mechanism – the bacteria cannot use the 5 carbon ring of Xylitol for metabolism in the same fashion they do of the six carbon ring of fructose, sucrose etc. The reduction in bacterial growth under the influence of Xylitol is recognised to be 90 %. Thus acid production is dramatically reduced1.

2) Because of reduced acid, the mouth pH remains neutral. Acid attack of the enamel and dentine is not possible in this environment.

3) Xylitol prevents bacteria adhering to the enamel and creating additional plaque volume1.

Xylitol and enamel damage repair

Research has shown that the use of xylitol also helps repair damage to the enamel. Saliva on its own protects the mouth and teeth. Under usual conditions, stimulated saliva in particular contains all the components needed to repair early cavities. If sugar is only taken a couple of times a day, saliva can manage the acids produced by bacteria and especially Strep. mutans. When people frequently snack, and where this food contains 6 carbon ring sugars, the mouth's in –built defensive mechanisms can be overwhelmed.  A common problem for mothers-to-be.

After taking xylitol products, the concentration of basic amino acids and ammonia in saliva and plaque rise, and plaque pH rises as well. When pH is above 7, calcium and phosphate salts in the saliva move into the weak and damaged areas of the enamel. Therefore, soft and calcium-deficient enamel sites are hardened..

Improving your personal health can begin sooner than later, and especially during your pregnancy, and xylitol can have a significant influence on that trend of reversing poor oral hygiene.


Teeth decay and Pregnancy

Expectant mothers experience major changes in their body during pregnancy, under the influence of the hormonal changes. The following influence the mouth cavity:

1. Morning sickness and nausea cause a change of the mouth bacterial flora and lead to a lower pH (more acidic)

2. Most mothers to be tend to snack more frequently, introducing sugar substrates into the mouth cavity more frequently.

Thus pregnant women are more prone to teeth decay, plaque build up and caries than before pregnancy. Interestingly, pregnant women tend to brush their teeth more frequently than non pregnant women, largely as a result of the above.


Safety evaluation of Xylitol

Xylitol is registered as a food additive and components of oral care products in the U.S., the EU, Australia, Japan, Canada and most developed nations.   This follows positive safety reviews by the WHO and FAO in 1983. Xylitol-based products are registered by the U.S. Food and Drug Administration (FDA)  to make the claim around effectiveness in preventing caries.

Xylitol has been shown to have decay-preventive qualities, especially for people at moderate to high risk for decay, when used as part of an overall strategy for decay reduction that also includes a healthy diet and good home care3.

Bacterial vertical transmission and xylitol

Studies show that Streptococcus mutans is passed from mothers to their newborn children, thus beginning the growth of these decay-producing bacteria in the child. Regular use of xylitol by mothers has been demonstrated to significantly reduce this bacterial transmission, resulting in fewer cavities for the child4.


Xylitol and antimicrobial activities

Xylitol affects the translocation of glucose across the bacterial cell wall  The highest xylitol concentration tested in this study, 1%, showed mean inhibition percentages ranging from 61% to 76% when the growth inhibition of the five strains was compared to the control without xylitol at log-phase.